Ten Take Home Lessons from the First 10 Years of the CTN and 10 Recommendations for the Future

Abstract

Background: The first 10 years of the National Institute on Drug Abuse’s Clinical Trials Network (CTN) yielded a wealth of data on the effectiveness of a number of behavioral, pharmacological, and combined approaches in community-based settings. Methods: We summarize some of the methodological contributions and lessons learned from the behavioral trials conducted during its first ten years, including the capacity and enormous potential of this national research infrastructure. Results: The CTN made contributions to the methodology of effectiveness research; new insights from secondary analyses; the extent to which approaches with strong evidence bases, such as contingency management, extend their effectiveness to real world clinical settings; new data on ‘standard treatment’ as actually practiced in community programs, the extent to which retention remains a major issue in the field; important data on the safety of specific behavioral therapies for addiction; and heightened the importance of continued sustained attention to bridging the gap between treatment and research. Conclusions: Areas of focus for the CTN’s future include defining common outcome measures to be used in treatment outcome studies for illicit drugs; incorporating performance indicators and measures of clinical significance; conducting comparative outcome studies; contributing to the understanding of effective treatments of comorbidity; reaching underserved populations; building implementation science; understanding long-term outcomes of current treatments and sustaining treatment effects; and conducting future trials more efficiently.

• behavioral trials
• Clinical Trials Network
• methodology

ACKNOWLEDGMENTS

This work was supported by the NIDA in the form of individual CTN grants to Yale University (U10 DA13038), the University of Washington (U10 DA 013714), Johns Hopkins University (U10 DA 13034), and McLean Hospital, Belmont, MA (U10 DA015831). Additional support was provided by NIDA grants P30-DA023918 (NMP), K24 DA022288 (RDW), and P50 DA 09241(KMC, SAB, SM). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIDA.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.